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Michigan Publishing

20-Year Risks of Breast-Cancer Recurrence after Stopping Endocrine Therapy at 5 Years

Overview of attention for article published in New England Journal of Medicine, November 2017
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  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (99th percentile)
  • High Attention Score compared to outputs of the same age and source (97th percentile)

Mentioned by

news
154 news outlets
blogs
4 blogs
policy
3 policy sources
twitter
330 X users
patent
2 patents
facebook
22 Facebook pages
googleplus
2 Google+ users
reddit
1 Redditor

Citations

dimensions_citation
993 Dimensions

Readers on

mendeley
963 Mendeley
citeulike
3 CiteULike
Title
20-Year Risks of Breast-Cancer Recurrence after Stopping Endocrine Therapy at 5 Years
Published in
New England Journal of Medicine, November 2017
DOI 10.1056/nejmoa1701830
Pubmed ID
Authors

Hongchao Pan, Richard Gray, Jeremy Braybrooke, Christina Davies, Carolyn Taylor, Paul McGale, Richard Peto, Kathleen I. Pritchard, Jonas Bergh, Mitch Dowsett, Daniel F. Hayes

Abstract

Background The administration of endocrine therapy for 5 years substantially reduces recurrence rates during and after treatment in women with early-stage, estrogen-receptor (ER)-positive breast cancer. Extending such therapy beyond 5 years offers further protection but has additional side effects. Obtaining data on the absolute risk of subsequent distant recurrence if therapy stops at 5 years could help determine whether to extend treatment. Methods In this meta-analysis of the results of 88 trials involving 62,923 women with ER-positive breast cancer who were disease-free after 5 years of scheduled endocrine therapy, we used Kaplan-Meier and Cox regression analyses, stratified according to trial and treatment, to assess the associations of tumor diameter and nodal status (TN), tumor grade, and other factors with patients' outcomes during the period from 5 to 20 years. Results Breast-cancer recurrences occurred at a steady rate throughout the study period from 5 to 20 years. The risk of distant recurrence was strongly correlated with the original TN status. Among the patients with stage T1 disease, the risk of distant recurrence was 13% with no nodal involvement (T1N0), 20% with one to three nodes involved (T1N1-3), and 34% with four to nine nodes involved (T1N4-9); among those with stage T2 disease, the risks were 19% with T2N0, 26% with T2N1-3, and 41% with T2N4-9. The risk of death from breast cancer was similarly dependent on TN status, but the risk of contralateral breast cancer was not. Given the TN status, the factors of tumor grade (available in 43,590 patients) and Ki-67 status (available in 7692 patients), which are strongly correlated with each other, were of only moderate independent predictive value for distant recurrence, but the status regarding the progesterone receptor (in 54,115 patients) and human epidermal growth factor receptor type 2 (HER2) (in 15,418 patients in trials with no use of trastuzumab) was not predictive. During the study period from 5 to 20 years, the absolute risk of distant recurrence among patients with T1N0 breast cancer was 10% for low-grade disease, 13% for moderate-grade disease, and 17% for high-grade disease; the corresponding risks of any recurrence or a contralateral breast cancer were 17%, 22%, and 26%, respectively. Conclusions After 5 years of adjuvant endocrine therapy, breast-cancer recurrences continued to occur steadily throughout the study period from 5 to 20 years. The risk of distant recurrence was strongly correlated with the original TN status, with risks ranging from 10 to 41%, depending on TN status and tumor grade. (Funded by Cancer Research UK and others.).

X Demographics

X Demographics

The data shown below were collected from the profiles of 330 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 963 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 963 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 129 13%
Student > Ph. D. Student 123 13%
Student > Master 91 9%
Other 89 9%
Student > Bachelor 76 8%
Other 163 17%
Unknown 292 30%
Readers by discipline Count As %
Medicine and Dentistry 301 31%
Biochemistry, Genetics and Molecular Biology 124 13%
Agricultural and Biological Sciences 44 5%
Pharmacology, Toxicology and Pharmaceutical Science 32 3%
Nursing and Health Professions 22 2%
Other 96 10%
Unknown 344 36%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1390. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 October 2023.
All research outputs
#8,690
of 24,914,266 outputs
Outputs from New England Journal of Medicine
#439
of 32,151 outputs
Outputs of similar age
#123
of 337,580 outputs
Outputs of similar age from New England Journal of Medicine
#8
of 275 outputs
Altmetric has tracked 24,914,266 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 32,151 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 121.8. This one has done particularly well, scoring higher than 98% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 337,580 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 275 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 97% of its contemporaries.